Eczema, also called atopic dermatitis, is a non-lethal medical condition associated with a profound negative impact on the quality of life. Characterized by severe itching and rash, the disease also takes a toll on mental and physical health.
More than 10 percent of the US population, including nearly 10 million children, suffer from eczema. The disorder usually begins in early childhood between the ages of 2 and 5 but 1 in 4 adults with no history of the disease will develop the condition. All ethnicities and races are affected almost equally, with Hispanic and African-American children experiencing more severe symptoms compared with Caucasian children.
Despite extensive research, eczema has no cure and incident rates are increasing every year. Recent scientific studies have provided clues about an association between autoimmune disorders and the correlation with atopic dermatitis that may provide better treatment options and hopefully a possible cure in the near future.
While researchers have failed to pinpoint a definitive cause for eczema, there is some evidence that gene mutations may be the culprit, along with a slew of environmental triggers that cause an overreaction in the immune system that leads to inflammation.
Mutations in the gene associated with filaggrin, a substance produced by the body to help protect the skin, have shown a strong correlation with the disease. When the protein filaggrin is inadequately produced in the body, dry and scaly skin develops which increases the ability for viruses and bacteria to penetrate the skin barrier and cause infection.
Emotional stress is also known to exacerbate symptoms but researchers aren't sure if stress triggers eczema symptoms or if the distress of eczema symptoms is the reason people identify stress as a trigger. Skin irritants like fragrances, smoke, and household cleaners are known to cause flare-ups. Some metals that come into contact with skin, especially nickel, can cause an immediate and severe eczema rash. Other common triggers include:
Severe itching and rash are the most prominent signs of atopic dermatitis. Scratching the areas affected can worsen the symptoms and cause raw and swollen skin. Itching may be especially troublesome at night which interferes with sleep and may lead to other stress-related conditions related to sleep loss.
The skin may become thickened, scaly and cracked which facilitates infection. Some people develop red or brownish gray patches, most commonly seen in the bend and creases of knees and elbows. Other parts of the body affected include:
In some cases, eczema causes fluid-filled, small raised bumps that appear crusty and flaky when scratched or disturbed. The blisters may also become infected and cause severe pain.
Eczema treatments cannot arrest the condition but focus mainly on controlling the severe itching, minimizing flare-ups and preventing skin infections. Creams, foams, gels, and ointments are used to reduce inflammation and relieve itching. Some people respond to over-the-counter medications but in some cases involving thick and scaly skin, prescription medications are needed. In severe cases, oral and injections may be needed to control symptoms. Non-steroidal prescription medications that inhibit inflammation and repair the skin have been developed to treat moderate to severe cases of eczema and include ointments applied directly to the skin.
In extremely hard to treat cases, systemic immunomodulators that weaken the immune system response have shown some effectiveness to ease itching and skin infections. Other treatments include:
Self-care also plays an important role in managing the condition. Daily moisturizers, infrequent warm baths, and limiting contact with known triggers may provide substantial relief and prevent flare-ups.
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